Confusing ADHD and Borderline Personality Disorder
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- เผยแพร่เมื่อ 30 ม.ค. 2023
- On the surface, ADHD, a neurodevelopmental condition affecting attention, hyperactivity, and impulsivity, has very little to do with Borderline Personality Disorder (BPD), a pervasive pattern of instability in relationships, self image and emotions. But the two conditions occur together more often than would happen by chance alone. Many adults receive one of these diagnoses, when the other diagnosis more accurately describes their challenges in the world. I'll explore reasons for this conditions, and some tips on differentiating ADHD from BPD.
It would make sense. Invalidating and abusive parents would most likely miss the signs that their children could be neurodivergent and just label them problematic and even abuse them and in that case, when seeking treatment, the doctor would see the outward manifestations of BPD as it is in the forefront and miss the ADHD diagnosis.
Thank you so much! extremally useful information as I learn about emotional dysregulation and ADHD. ADHD is so minimized that I never connected my emotional intensity and rapid cycling with the one diagnosis that I've had and everyone in my life has confirmed is very strong, ADHD!
I'm glad that this was of some help in sorting things out and in self understanding.
Yeh, I would agree, it's the excessive rage that differentiates BPD and ADHD. With ADHD it's more frustration in the moment that can come to the surface. With BPD the impulsivity includes the impulse to lash back and it doesn't need to be overt like shouting. It can be something really sneaky and even dangerous like putting a pin on someone chair in the moment. The focusing and concentration problems are different for BPD. More to do with the ability to process the meanings of words and a tendency to interpret expressions and what people say more negatively which is what leads to the anger issues, and tends to be stress based. With ADHD it's more general lack of concentration - losing time - and although it can get worse with stress it's not to the same extent and it's present ALL the time.
Yes.
Thanks Dr. Kruse
You're welcome!
This makes a lot of sense
Thank you thank you, i have the borderline characteristic of being so romantic, and tend to give all my attention and then suffocating the other person... now i had kind of controlled it, but it is in me. But i am not an angry person, i am almost a doormat, on the other hand i am very intense with joy, regret, but not angry... Seeing ADHD as the root cause for my romantic problems is good. I also have many many many successful good friendships. So i really think that my severe ADHD combined with my high emotional inteligent person and a romantic, makes me behave like a borderline in romanctic relationship
I'm glad that you found this helpful.
I have to live with this patient. After the doctor concluded that he was, I try to understand the different relapses. And of course, even though I knew it was caused by his disease but maybe I can't stand it anymore. I was abused when he ate too much. I felt pity and anger at the patient at the same time. I feel like talking to a doctor or a specialist in my country and I feel like it might not help. And in the end, I might have to get sick too. I wish my country had some experts like you.
Sometimes understanding the reasons for someone else's behavior can make things better. But I often encourage people to focus on the behavior itself. If the behavior is not acceptable to you, or puts you in danger then it may be more important to protect yourself and distance yourself from the behavior, rather than sorting out why the other person behaves that way.
@@dr.johnkruse6708 You made me feel not alone. Thank you very much.
Thanks for this video. I've thought about the connection between ADHD and BPD and it seems to me like you explain there's a lot more that connects them that meets the eye. For example, what do you think of the theory that ADHD is a flight based response to trauma? Where by flight I refer to one of the four Fs (fight, flight, freeze, fawn). So a person with ADHD adapted to cope with the pain that comes with trauma with behaviors mostly related to distraction.
I also have noticed the trauma of people with ADHD seems to originate lot more from neglect from caregivers rather than from abuse. Whereas from BPD it's a lot more abuse related and or severe neglect. My impression being then that ADHD and BPD are both ways to cope with trauma, where what determines what one gets is the type of trauma, the intensity, and genetic make-up.
I am aware that people with ADHD are more likely than others to have traumatic events in their life. I'm also aware that PTSD can mimic a lot of ADHD symptoms. But I think we need to continue to push back against the narrative that trauma is the major explanation for ADHD. Many people with ADHD can't find any trauma in their past, and the adoption and genetic studies indicate a very strong biological propensity to develop ADHD. Some of the writers who strongly promote the trauma-ADHD connection sound to me like the 1950's psychoanalysts who blamed mothers for schizophrenia and homosexuality. Worse, some of these authors write very convincingly, and empathetically, so they get many people with ADHD to endorse this framework that if I only had more attentive/nourishing parents then I wouldn't have to deal with ADHD.
I've been diagnosed with ADHD for over 15 years. Turns out, I think your borderline thesis of it being a secondary joint version of it is right on the dot. Also, qudrapeds tend to think ADHD people are dumb or stupid. We are exceptionally smarter than many average "infidels of pre-disposed assumption" and very good at retaining information as sponges. Those that classify and "label" just tend to associate us with Spongebob Squarepants antics. This may not necessarily be the case, although we do enjoy them on a theatrical scale of grouped familiarity. This an intelligent analysis FOR ONCE.
General itelligence rates of adhd vs neurotypical is approximately the same, with ADHD generally being slightly less 🤷♂️
Wow, that escalated quickly!
Not for this ADHDior. I'm an execptional alien breed.
That is BS. @@Adam-zw1ck
There is a lot of research on ADHD and intelligence which shows that there is no significant differences in intellectual abilities between those with ADHD and the general population. Some people with ADHD have high IQ but some also have low IQ and most are in the middle.
I'm a retired professor with ADHD.
very interesting
Im very impulsive when it comes to anger, like i would think ok im getting angry there is adrenaline rushing and you can lash out if anyone ask you something or talk, so try not to , and be polite while being assertive, but then i lash out its like a strong impulse i cant control i think i have ADD isntead of BPD cuz other than anger outburts and i just like online shopping whenever i have money because im interested in fashion and i have noticed that when i enter a mall i end up buying nore then i intended, but i am not sure its BPD tho, but you pointed out that if the anger is the only emotion that is extreme than i guess its BPD, its like i feel bad i feel guilty i feel hurt its stressful i lash out in anger, from numerous experiences recently i got backstabbed by number of people,so i stopped trusting people but i dont have abandonment issues, i do have ADD tho, ever since childhood my teacher would complain how i always make silly mistake and i am careless and im 25 and still dont notice most of the things, my partner would get upset because i didnt notice he groomed up or got a haircut, im very good at college, a top student, but i do have people i can still rely on, however i have anger problems for as long as i remember even as i child i would be constantly yelling etc, so i dont know if its a sign of BPD or ADD because i dont have amy hyperactive symptoms. One more thing is that i remain anxious, but the anxiety is in my body, the tension in muscles etc, but not due to cognition and i figured its mainly because my mother has anxiety and add as well and my nervous system has adopted to mirror hers, but im still confused by my anger, i dont have any self harm or suicidal behavior or unsafe behavior or drug addiction.
Thanks for sharing. As I mention, a clinical evaluation by someone who knows both ADD and BPD would be the best ways to sort out what is going on, and there are certainly some people with both.
Excellent topic doc. Thanks. I've just begun reading the new 3rd edition of 'I Hate You -Don't Leave Me', so this is timely for me. It's such a good book. I've been skipping around, and did see that ICD11 lists Emotionally Unstable (or dysregulated?) Personality and not BPD. Since the rates of comorbidity are quite high, I wonder whether a big chunk of the suicidality in ADHD might be associated with undiagnosed BPD, or a preponderance of borderline traits that may not meet 5 of 9 for the DSM criteria. (There's also an alternative diagnostic criteria in DSM that's said to be more dimensional). It really seems that BPD is at least half neurological and/or genetic based on twin studies, and that there are some common genetic differences in ADHD and Borderline Personality.
Your story of the patient who contacted 57 clinicians is just tragic. I would've given up. Clearly it can be a matter of life and death. These authors cite studies showing that 75% of borderline patients no longer have the diagnosis of personality *disorder* after only 2 years of treatment. They also describe a number of comparable effective therapies in addition to DBT. The reluctance to diagnose/treat BPD doesn't seem to be doing anyone any favors.
BPD may account for a big proportion of suicides in ADHD, but I think we are still underestimating the role of impulsivity in suicide. Nationwide suicide rates did not increase during the COVID lockdowns, despite significant increases in depression, anxiety, alcoholism, and misery. I think that being locked down with other individuals decreased the opportunities where impulsive actions could quickly lead to death.
Some have speculated that the reports of high success rates of alleviating BPD in a year or two really reflect people who are either on the milder end of the BPD spectrum, or even misdiagnoses (such as women with hyperactive ADHD).
@@dr.johnkruse6708 thank you. I understand what you're saying. This topic is important. I don't believe in stigmatizing neurological differences.
@@dr.johnkruse6708- suicide rates went down for the pandemic, but sure came back with a vengeance. What do you think of the current high? And isn't there also an argument that it wasn't lack of social isolation to allow moments of impulsivity, but the greater sense of community that comes after events like 9/11?
@@publius9350 I'm not aware of any research that suggested an increased sense of community in the US during the pandemic. If that had been the case, we would have expected depression, anxiety, domestic violence and substance abuse to decrease as well, which they did not. I think the current high is consistent with the trends of the last decade or more, and in my mind is a reflection of all the environmental and social threats to human life on earth that we are not yet adequately addressing, and which social media can remind us of multiple times a day.
@@dr.johnkruse6708 - just that it has long been suggested that suicide rates decline in the face of outside threats and the pandemic could be considered such. I'm not sure that there are studies saying that the isolation with other individuals inhibited the impulsiveness either. Some people certainly had *more* time alone. Basically, aren't we just spit balling possible causes, or is there some data about fewer moments of isolation to allow impulsivity? The community feeling was more so that while we may have lost a number of things, we felt that everyone had lost simultaneously, and thus a loss of jobs or friends would not be viewed as an individual failure. Others might value life more seeing the number of people dying. Still resulting in depression and substance use, but not the sense of perceived burden above that which was sensed by all. While afterwards we have returned to a sense of a dog eat dog world, and the social media cultural sphere shows again the things a person does not have, while during the pandemic it would show the shared sense of loss, and a shaming of those who did not join in quarantine and self seclusion.
Would you consider showing chronic favoring od 1 child over the other would also contribute to the invalidating home?
That sounds to me that it would have been invalidating.
So is BPD something that is developed or something you’re born with? I feel like I identify strongly with the rejection sensitivity of ADHD. As a kid I cried all the time when I felt I was criticized, rejected, or left out, even if I really wasn’t. I stopped crying about it around 12-13 years old. But the inner feelings I get still largely remain, I just don’t express it. I wound up ruining a potential relationship with the perfect girl over me feeling rejected when I flirted a little too hard too early. She even said it wasn’t a big deal to her, but to me it felt huge and I lost my spark with her despite still liking everything about her.
However I feel like I do identify a lot with BPD the older I’ve gotten (now 25.)
Our current understanding is that you may be born with a propensity for developing it, but it also takes specific environments and experiences for it to develop.
@@dr.johnkruse6708 alright thank you
Yeah I’m close to what you said. Just started adhd meds. Concerta and it help tremendously with my emotions regulating. But not working for stimulanttinf me making me more interested . But it’s help wkrh my depression so I can’t complain.
There is something called Rejection Dysphoria (RD) that I have seen to be strongly associated with ADHD. There are a few ADHD TH-camrs who talk about it. But I'm not an expert. Just passing along that information.
Emotional dysregulation is a big thing in ADHD, but it should be a "normal" emotional reaction to something, but the emotion is less inhibited or suppressed. Like, you feel what anyone else would feel, but others are better able to self-soothe. Whereas with BPD, the level of emotion and the reaction itself are just inappropriate or do not match the event. Like the emotion is too big, wrong (unjustified anger), or goes on for way too long. I think mood disorders too, but are not as much of an up and down reaction in the course of a day. That's the sense I get from what I've been learning.
Good luck!
@@ilikepingpong my 20th video on this channel was about Rejection Sensitive Dysphoria:
th-cam.com/video/jJ27eZ-d8FI/w-d-xo.html
It is an inexact term, with people tending to use it to refer to what they want it to mean. The label clearly resonates with many people with ADHD, and introduces many people to the idea of emotional volatility being part of ADHD. The biggest proponent of the term has repeatedly claimed that everyone with ADHD has it, and that it is unique to ADHD. I don't find either of these claims to be reasonable or what I have seen in my clinical work.
I have been researching bpd and npd to see if my girlfriend has bpd or npd only to realize that I now think I am the one with bpd. I am also diagnosed adhd and depression.
It sounds like it may be useful to talk with a skilled therapist to try to get an outside assessment of what might be going on.
It’s very simple so if you have ice cream and ADHD is vanilla ice cream borderline ice cream is like Ben & Jerry’s there you go that’s simple when you are in a BPD relationship you feel like it is the first time you’ve stepped into hell as regards to a relationship that’s romantic
I think you are underestimating the chaos and social strife that severe ADHD, in the absence of personality disorders, can cause.
Hello, Doc. If you could help me, I'd greatly appreciate it. I have a few questions.
I was involved with a whom I suspected woman may be an undiagnosed Narc. Her daughter is a diagnosed borderline personality disorder. Based on my research and understanding of BPD, I believe that the daughter is the real deal. But the mother, I am not sure what's her problem.
So the mother likes to tell me and everyone that she used to be a successful and an established architect, painter, a musician, a pilot, a nurse and a millionaire, and even a target for assassination. She claims to have been living in a mansion and rescuing animals. She even claimed that her son was a college professor, but upon meeting her son he told me, no, he is just a student. I checked her out on public records, but only "nursing assistant" appeared on her record. She is always asking for my help. She says that she is sick (she is a hypochondriac). She has gastritis and feels bugs crawling on her skin, or that someone is trying to poison her. She spends the majority of her time at home, alone. She feels better when I am with her. She doesn't work, she is on disability, but she loves to say that she is "working" or "I just got done with work". She lives with her young daughter. She has bad dentures (possibly meth mouth or history of drug abuse?) and she blames it on her daughter. She tells her daughter that her daughter's BDP diagnosis was a setup to make her appear crazy and take her away from the mother. After CPS took her daughter away to foster, the mother faught long and hard to reclaim her daughter after 2.5 years. She claims that she never done drugs and that she lost everything she had because of the government and her daughter. The son told me in confidant that when he was 10, she hit him so hard on his head for no reason, that he quickly decided to move in with his dad. She emotionally/verbally abuses her daughter. She calls her little shit and prostitute or says things like she hopes she gets raped and killed, but then says that she didn't mean it like that. She says that she loves her daughter and that it is normal among parants. Daughter said to me that she cut herself because of her mother's verbal abuse. Mother said , "no, you cut yourself because of the trauma inflicted by CPS and the foster care system".
Daughter also said that she gets panic attacks whenever her cell phone rings because she fears the mother (I, too, was getting panic attacks from hearing my own cellphone ring because the mother constantly calls me without regard). But then there are days when the mother is loving and affectionate towards daughter.
1). Is this person a narcissist?
I went no contact with this woman and the daughter. They have tried to hoover me back in but I rejected their advances. Well, recently I had a dream that the mother was depressed, lonely and heartbroken, then I feel a pain in my heart/chest and I have been feeling that pain for that past couple of days. I know, go see a doctor, but I have had numerous echoes and EKGs for this problem in past, and the test results always came back negative.
2). Why am I heartbroken for someone that was clearly bad?
When I was in elementary and middle school, a lot of my teachers said that I may have ADD/ADHD, because I was very hyperactive, talkative and impulsive. But the one thing that the teachers didn't know was that my mother was abusive to me ever since I could remember. It may even be possible that my speech impediment/stutter was caused by my mother striking me on my head with a broomstick when I was 6 or 7. I grew up with very low self esteem and my classmates calling me weird/strange.
Is it possible that I may have had undiagnosed borderline personality disorder and not ADHD as my teachers thought?
Anything is possible, and from the information provided I would not be able to make a diagnosis. But this woman seems to need serious professional help, whether or not she is willing to seek it or accept it. It is unlikely that you being present and nice to her will resolve most of her conflicts with herself and the world.
I didn't read much in your description of yourself or your interactions with others that would strongly indicate BPD fits for you. But I would suggest reading more about both ADHD and BPD and seeing what resonates and what doesn't. Again, it may be helpful for you to see a professional that could explore these diagnostic questions in more detail.
@@dr.johnkruse6708 Thank you, Dr. John Kruse.
How about RSD that is connected to ADHD looking like BPD?
I have a talk on this channel about Rejection Sensitive Dysphoria, and yes there would be considerable overlap between RSD and BPD.
Why's it seem like he's got a suction machine under his desk right now talking to me. Why's he talking like that, getting sweaty, and moving up and down and pausing and just shaking
I'm not sure what sweating and shaking you're seeing.
😂